Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation

Hun Lee; David Sung Yong Kang; Byoung Jin Ha; Jin Young Choi; Eung Kweon Kim; Kyoung Yul Seo; Tae Im Kim

doi:10.1186/s12886-017-0666-1

Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation

Hun Lee, David Sung Yong Kang, Byoung Jin Ha, Jin Young Choi, Eung Kweon Kim, Kyoung Yul Seo, Tae Im Kim

Department of Ophthalmology

Research output: Contribution to journal › Article › peer-review

10 Citations (Scopus)

Abstract

Background: To investigate the effects of combined corneal wavefront-guided transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) after intracorneal ring segment (ICRS) implantation in patients with moderate keratoconus. Methods: Medical records of 23 eyes of 23 patients undergoing combined tPRK and CXL after ICRS implantation were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, higher-order aberrations (HOAs), and corneal biomechanical properties were evaluated before and after ICRS implantation, and at 1, 3, and 6 months after combined tPRK and CXL. Results: There were significant improvements in final logMAR UDVA and logMAR CDVA, and reductions in sphere, MRSE, and all corneal indices from baseline. Significant improvements in logMAR UDVA and reductions in sphere, MRSE, maximal keratometry, keratometry at the apex, mean keratometry, and keratoconus index were noted after ICRS implantation. After tPRK and CXL, significant improvements in logMAR UDVA and logMAR CDVA, and reductions in cylinder and all corneal indices were observed. There were significant improvements in final root mean square HOAs and coma aberrations from baseline, but no changes from baseline after ICRS implantation. Significant reductions in final radius and deformation amplitude from baseline were noted. Conclusions: Combined tPRK and accelerated CXL after ICRS implantation in moderate keratoconus appears to be a safe and effective treatment, providing an improvement in visual acuity, corneal indices, and HOAs. Trial registration: retrospectively registered (identification no. NCT03355430). Date registered: 28/11/2017.

Original language	English
Article number	270
Journal	BMC Ophthalmology
Volume	17
Issue number	1
DOIs	https://doi.org/10.1186/s12886-017-0666-1
Publication status	Published - 2017 Dec 29

Bibliographical note

Funding Information:
This research was partially supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2016R1A2B4009626) and by research fund of Catholic Kwandong University International St. Mary’s Hospital (CKURF-201604890001). The funding agencies had no role in the design or conduct of this study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

Publisher Copyright:
© 2017 The Author(s).

All Science Journal Classification (ASJC) codes

Ophthalmology

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Lee, H., Kang, D. S. Y., Ha, B. J., Choi, J. Y., Kim, E. K., Seo, K. Y., & Kim, T. I. (2017). Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation. BMC Ophthalmology, 17(1), [270]. https://doi.org/10.1186/s12886-017-0666-1

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title = "Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation",

abstract = "Background: To investigate the effects of combined corneal wavefront-guided transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) after intracorneal ring segment (ICRS) implantation in patients with moderate keratoconus. Methods: Medical records of 23 eyes of 23 patients undergoing combined tPRK and CXL after ICRS implantation were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, higher-order aberrations (HOAs), and corneal biomechanical properties were evaluated before and after ICRS implantation, and at 1, 3, and 6 months after combined tPRK and CXL. Results: There were significant improvements in final logMAR UDVA and logMAR CDVA, and reductions in sphere, MRSE, and all corneal indices from baseline. Significant improvements in logMAR UDVA and reductions in sphere, MRSE, maximal keratometry, keratometry at the apex, mean keratometry, and keratoconus index were noted after ICRS implantation. After tPRK and CXL, significant improvements in logMAR UDVA and logMAR CDVA, and reductions in cylinder and all corneal indices were observed. There were significant improvements in final root mean square HOAs and coma aberrations from baseline, but no changes from baseline after ICRS implantation. Significant reductions in final radius and deformation amplitude from baseline were noted. Conclusions: Combined tPRK and accelerated CXL after ICRS implantation in moderate keratoconus appears to be a safe and effective treatment, providing an improvement in visual acuity, corneal indices, and HOAs. Trial registration: retrospectively registered (identification no. NCT03355430). Date registered: 28/11/2017.",

author = "Hun Lee and Kang, {David Sung Yong} and Ha, {Byoung Jin} and Choi, {Jin Young} and Kim, {Eung Kweon} and Seo, {Kyoung Yul} and Kim, {Tae Im}",

note = "Funding Information: This research was partially supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2016R1A2B4009626) and by research fund of Catholic Kwandong University International St. Mary{\textquoteright}s Hospital (CKURF-201604890001). The funding agencies had no role in the design or conduct of this study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2017 The Author(s).",

year = "2017",

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doi = "10.1186/s12886-017-0666-1",

language = "English",

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Lee, H, Kang, DSY, Ha, BJ, Choi, JY, Kim, EK , Seo, KY & Kim, TI 2017, 'Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation', BMC Ophthalmology, vol. 17, no. 1, 270. https://doi.org/10.1186/s12886-017-0666-1

Visual rehabilitation in moderate keratoconus : Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation. / Lee, Hun; Kang, David Sung Yong; Ha, Byoung Jin et al.

In: BMC Ophthalmology, Vol. 17, No. 1, 270, 29.12.2017.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Visual rehabilitation in moderate keratoconus

T2 - Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation

AU - Lee, Hun

AU - Kang, David Sung Yong

AU - Ha, Byoung Jin

AU - Choi, Jin Young

AU - Kim, Eung Kweon

AU - Seo, Kyoung Yul

AU - Kim, Tae Im

N1 - Funding Information: This research was partially supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2016R1A2B4009626) and by research fund of Catholic Kwandong University International St. Mary’s Hospital (CKURF-201604890001). The funding agencies had no role in the design or conduct of this study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication. Publisher Copyright: © 2017 The Author(s).

PY - 2017/12/29

Y1 - 2017/12/29

N2 - Background: To investigate the effects of combined corneal wavefront-guided transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) after intracorneal ring segment (ICRS) implantation in patients with moderate keratoconus. Methods: Medical records of 23 eyes of 23 patients undergoing combined tPRK and CXL after ICRS implantation were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, higher-order aberrations (HOAs), and corneal biomechanical properties were evaluated before and after ICRS implantation, and at 1, 3, and 6 months after combined tPRK and CXL. Results: There were significant improvements in final logMAR UDVA and logMAR CDVA, and reductions in sphere, MRSE, and all corneal indices from baseline. Significant improvements in logMAR UDVA and reductions in sphere, MRSE, maximal keratometry, keratometry at the apex, mean keratometry, and keratoconus index were noted after ICRS implantation. After tPRK and CXL, significant improvements in logMAR UDVA and logMAR CDVA, and reductions in cylinder and all corneal indices were observed. There were significant improvements in final root mean square HOAs and coma aberrations from baseline, but no changes from baseline after ICRS implantation. Significant reductions in final radius and deformation amplitude from baseline were noted. Conclusions: Combined tPRK and accelerated CXL after ICRS implantation in moderate keratoconus appears to be a safe and effective treatment, providing an improvement in visual acuity, corneal indices, and HOAs. Trial registration: retrospectively registered (identification no. NCT03355430). Date registered: 28/11/2017.

AB - Background: To investigate the effects of combined corneal wavefront-guided transepithelial photorefractive keratectomy (tPRK) and accelerated corneal collagen cross-linking (CXL) after intracorneal ring segment (ICRS) implantation in patients with moderate keratoconus. Methods: Medical records of 23 eyes of 23 patients undergoing combined tPRK and CXL after ICRS implantation were retrospectively analyzed. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), corneal indices based on Scheimpflug tomography, higher-order aberrations (HOAs), and corneal biomechanical properties were evaluated before and after ICRS implantation, and at 1, 3, and 6 months after combined tPRK and CXL. Results: There were significant improvements in final logMAR UDVA and logMAR CDVA, and reductions in sphere, MRSE, and all corneal indices from baseline. Significant improvements in logMAR UDVA and reductions in sphere, MRSE, maximal keratometry, keratometry at the apex, mean keratometry, and keratoconus index were noted after ICRS implantation. After tPRK and CXL, significant improvements in logMAR UDVA and logMAR CDVA, and reductions in cylinder and all corneal indices were observed. There were significant improvements in final root mean square HOAs and coma aberrations from baseline, but no changes from baseline after ICRS implantation. Significant reductions in final radius and deformation amplitude from baseline were noted. Conclusions: Combined tPRK and accelerated CXL after ICRS implantation in moderate keratoconus appears to be a safe and effective treatment, providing an improvement in visual acuity, corneal indices, and HOAs. Trial registration: retrospectively registered (identification no. NCT03355430). Date registered: 28/11/2017.

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Visual rehabilitation in moderate keratoconus: Combined corneal wavefront-guided transepithelial photorefractive keratectomy and high-fluence accelerated corneal collagen cross-linking after intracorneal ring segment implantation

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

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